Provider Demographics
NPI:1093202582
Name:EHRLICH, LAUREN E (PHD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:EHRLICH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:EILEEN
Other - Last Name:KNAUF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:434-295-1000
Mailing Address - Fax:
Practice Address - Street 1:1215 LEE ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-3363
Practice Address - Country:US
Practice Address - Phone:434-924-2231
Practice Address - Fax:434-924-9295
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1545103T00000X, 103TC0700X
VA0810007315103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist